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  • Form C-112 - Ohio Bureau Of Workers' Compensation

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Employer/Employee Agreement to Select a State Other Than Ohio as the State of Exclusive Remedy for Workers Compensation Claims Please read below before completing this form An employee who enters.

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In terms of processing time, the BWC maintains a 28-day turnaround time for all Ohio workers' compensation claims. Within that 28-day period, the BWC will review the FROI and make a decision as to approval or denial of the underlying claim.

OhioBWC - Worker - Form: (BWC Forms) - Injured Worker Forms Descriptions. Injured worker forms descriptions. A-12 EFT - A.C.T. Enrollment Form and Direct Deposit Authorization: Injured workers should use this form to apply for direct deposit of their workers' compensation payments.

U-3E - Application for Exemption from Ohio Workers' Coverage and Waiver of Benefits Employers use this form to apply for religious exemption from paying BWC premiums or assessments, or for self-insuring employers paying compensation and benefits directly to their employees who completed the form.

OhioBWC - Common - Form: (C-11) - Introduction. Injured workers, employers, medical providers or authorized representatives should use this form to appeal the managed care organization's (MCO's) medical treatment/service decision. This form initiates the alternative dispute resolution (ADR) process.

With the Go-Green Rebate Program, employers can receive a 1-percent premium rebate, up to $2,000 each policy year. Go-Green requires employers to use this website to: Enroll in electronic notifications and opt to receive policy notices electronically prior to completing the payroll true-up report.

BWC issues certificates of coverage to employers after they submit an Application for Workers' Compensation Coverage (U-3) and pay a non-refundable application fee of $120. They'll also receive a new certificate at the beginning of each policy year.

In Ohio, all employers with one or more employees must, by law, have workers' compensation coverage. Coverage for Ohio employers and their employees becomes effective when BWC receives: A completed Application for Ohio Workers' Compensation Coverage (U-3). $120 (minimum) non-refundable application.

How do you file a claim? Online: Complete the First Report of Injury, Occupational Disease or Death (FROI). Mail or Fax: Print the (FROI), complete it, and then submit it to BWC by mail or fax to 866-336-8352. ... Phone: Call BWC at 800-644-6292 from 7:30 a.m. to 5:30 p.m. (EST) or a local BWC customer service office.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232